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Use of statins and the risk of dementia and mild cognitive impairment: A systematic review and meta-analysis.

ABSTRACT: We conducted a systematic review and meta-analysis to investigate whether the use of statins could be associated with the risk of all-caused dementia, Alzheimer's disease (AD), vascular dementia (VaD), and mild cognitive impairment (MCI). Major electronic databases were searched until December 27^th, 2017 for studies investigating use of statins and incident cognitive decline in adults. Random-effects meta-analyses calculating relative risks (RRs) were conducted to synthesize effect sizes of individual studies. Twenty-five studies met eligibility criteria. Use of statins was significantly associated with a reduced risk of all-caused dementia (k?=?16 studies, adjusted RR (aRR)?=?0.849, 95% CI?=?0.787-0.916, p?=?0.000), AD (k?=?14, aRR?=?0.719, 95% CI?=?0.576-0.899, p?=?0.004), and MCI (k?=?6, aRR?=?0.737, 95% CI?=?0.556-0.976, p?=?0.033), but no meaningful effects on incident VaD (k?=?3, aRR?=?1.012, 95% CI?=?0.620-1.652, p?=?0.961). Subgroup analysis suggested that hydrophilic statins were associated with reduced risk of all-caused dementia (aRR?=?0.877; CI?=?0.818-0.940; p?=?0.000) and possibly lower AD risk (aRR?=?0.619; CI?=?0.383-1.000; p?=?0.050). Lipophilic statins were associated with reduced risk of AD (aRR?=?0.639; CI?=?0.449-0.908; p?=?0.013) but not all-caused dementia (aRR?=?0.738; CI?=?0.475-1.146; p?=?0.176). In conclusion, our meta-analysis suggests that the use of statins may reduce the risk of all-type dementia, AD, and MCI, but not of incident VaD.

SUBMITTER: Chu CS

PROVIDER: S-EPMC5895617 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Use of statins and the risk of dementia and mild cognitive impairment: A systematic review and meta-analysis.

Chu Che-Sheng CS Tseng Ping-Tao PT Stubbs Brendon B Chen Tien-Yu TY Tang Chia-Hung CH Li Dian-Jeng DJ Yang Wei-Cheng WC Chen Yen-Wen YW Wu Ching-Kuan CK Veronese Nicola N Carvalho Andre F AF Fernandes Brisa S BS Herrmann Nathan N Lin Pao-Yen PY

Scientific reports 20180411 1

We conducted a systematic review and meta-analysis to investigate whether the use of statins could be associated with the risk of all-caused dementia, Alzheimer's disease (AD), vascular dementia (VaD), and mild cognitive impairment (MCI). Major electronic databases were searched until December 27<sup>th</sup>, 2017 for studies investigating use of statins and incident cognitive decline in adults. Random-effects meta-analyses calculating relative risks (RRs) were conducted to synthesize effect si ...[more]

PMID: 29643479

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Project description:Background: More people with cognitive dysfunction and dementia also fall into the category of high vascular risk, for which aspirin is one of the most frequently used drugs. However, previous studies reporting that aspirin buffers against mild cognitive decline (MCI) and dementia remain controversial. We thus conducted an updated systematic review and meta-analysis to evaluate the association of aspirin use with the risk of MCI and dementia in older adults. Methods: Data sources from PubMed, Embase, Web of Science, and the Cochrane Database for randomized controlled trails (RCTs) and cohort studies (published between January 1, 2000 and April 11, 2020). Relative risks (RRs) and 95% confidence intervals (95% CIs) were used to pool data on the occurrence of dementia and MCI with random-effects models. Results: Of 3,193 identified articles, 15 studies (12 cohort studies and three RCTs) were eligible and were included in our analysis, which involved a total of 100,909 participants without cognitive dysfunctions or dementia at baseline. In pooled cohort studies, aspirin use did not reduce the incidence of MCI and dementia (the pooled RR = 0.97; 95% CI = 0.85-1.11; Ifor heterogeneity2 = 65%) compared with non-users. However, low-dose aspirin (75-100 mg/day) was associated with a decreased likelihood of developing dementia or MCI (the pooled RR = 0.75; 95% CI = 0.63-0.9; Ifor heterogeneity2 = 50.5%). This association existed in studies including all-cause dementia (the pooled RR = 0.82; 95% CI = 0.71-0.96) and Alzheimer's disease (AD) (the pooled RR = 0.54; 95% CI = 0.33-0.89), but not in MCI (the pooled RR = 0.58; 95% CI = 0.31-1.08). In RCTs, low-dose aspirin use was not significantly associated with less prevalence of dementia or MCI (RR = 0.94; 95% CI = 0.84-1.05; Ifor heterogeneity2 = 0.0%). Conclusions: In cohort studies, we found that low-dose aspirin use had a higher likelihood of reducing the incidence of dementia, which was not supported by RCTs. The evidence was insufficient to fully evaluate the effect of aspirin on cognitive function and dementia. Well-designed studies and innovative approaches are therefore needed to clarify whether the use of aspirin improves cognitive function and reduces the risk of dementia.

Project description:INTRODUCTION:Persisting neurotropic viruses are proposed to increase the risk of dementia, but evidence of association from robust, adequately powered population studies is lacking. This is essential to inform clinical trials of targeted preventive interventions. METHODS AND ANALYSIS:We will carry out a comprehensive systematic review of published and grey literature of the association between infection with, reactivation of, vaccination against or treatment of any of the eight human herpesviruses and dementia or mild cognitive impairment. We will search the Cochrane Library, Embase, Global Health, Medline, PsycINFO, Scopus, Web of Science, clinical trials registers, the New York Academy of Medicine Grey Literature Report, Electronic Theses Online Service through the British Library and the ISI Conference Proceedings Citation Index for randomised controlled trials, cohort, caseâ€"control, case crossover or self-controlled case series studies reported in any language up to January 2017. Titles, abstracts and full-text screening will be conducted by two researchers independently. Data will be extracted systematically from eligible studies using a piloted template. We will assess risk of bias of individual studies in line with the Cochrane Collaboration tool. We will conduct a narrative synthesis, grouping studies by exposure and outcome definitions, and will describe any differences by population subgroups and dementia subtypes. We will consider performing meta-analyses if there are adequate numbers of sufficiently homogeneous studies. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development and Evaluations criteria. ETHICS AND DISSEMINATION:As this is a review of existing studies, no ethical approval is required. Results will be disseminated through a peer-reviewed publication and at national and international conferences. We anticipate the review will clarify the current extent and quality of evidence for a link between herpesviruses and dementia, identify gaps and inform the direction of future research. PROSPERO REGISTRATION NUMBER:CRD42017054684.

Dataset Information

Use of statins and the risk of dementia and mild cognitive impairment: A systematic review and meta-analysis.

Publications

Use of statins and the risk of dementia and mild cognitive impairment: A systematic review and meta-analysis.

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